The joints of the human body withstand daily stress, so they are sensitive to various types of destructive factors. Osteoarthritis is a common disease of the joints, affecting both large and small joints. Osteoarthritis of the knee joint is a degenerative-dystrophic damage of the knee joint, its motor function is impaired. Without proper treatment, the disease can lead to disability.
Because the disease caused characteristic deformities in the joint, it was called deforming arthrosis of the knee joint, which rightly describes the typical characteristic of the pathology. The disease is chronic and is more often diagnosed in women who are overweight and suffering from venous pathologies of the lower extremities, but there may be other causes. It also occurs in older people due to age-related changes.
Osteoarthritis in young people can cause injuries. As a result of degenerative-dystrophic changes, cartilage softens, erodes and is covered with cracks of different depths. It then ceases to perform its function.
Reasons
Various causes cause the appearance of deforming arthrosis of the knee joint. Traumatic factor is a common cause. Post-traumatic osteoarthritis can develop as a result of dislocation or fracture in the specified area, as well as damage to the meniscus. Gonarthrosis of the knee joint is more common in young people who are active in sports or in people whose work is associated with increased mobility, lifting and carrying heavy loads.
Few people know that such an injury can be the result of treatment, when the injury itself has already healed, but during prolonged immobilization of the joint, circulatory disorders have occurred in this area. Therefore, gonarthrosis appeared.
Increased physical activity in the knee is one of the leading factors in the onset of the disease. It most often affects athletes with constant active loads on the knee. Osteoarthritis does not manifest itself at a young age, usually rapid changes begin after cessation of physical activity.
There is also a risk of disease in people who do not reduce the load on such joints during adolescence. Such athletes have an increased risk of fractures and dislocations, and microtraumas are visible. Therefore, after forty years, doctors advise athletes to reduce the load and switch to coaching. Running and squats are best avoided because they are the most stressful activities for the knee joint. Often one limb is injured and left-sided gonarthrosis or right-sided gonarthrosis occurs.
An important factor in the development of osteoarthritis of the knee joint is the removal of the meniscus. If for some reason the meniscus is removed, then in 90 percent of cases it causes the appearance of osteoarthritis - the so-called curvature of the knee, in which case the articular joints experience more friction than usual.
The problem of excess weight is also relevant for people with osteoarthritis. Excessive body weight puts unnecessary pressure on the joints. As a result, not the cartilage itself, but the meniscus is damaged. Excess weight and the combination of varicose veins of the lower extremities create the danger of appearing acute osteoarthritis.
In some patients, a weak ligament is a congenital feature, and sometimes the ligaments are affected by other diseases. In one way or another, weak ligaments cause increased mobility in the joint, so the articular surfaces are significantly eroded. The effects of weak ligaments may not be felt for long until patients show signs of true osteoarthritis.
Articular pathologies also contribute to the development of the disease. The most common cause of osteoarthritis is arthritis - an inflammation of the joints. Typical symptoms of arthritis are deterioration of synovial fluid, pathological changes in cartilage, swelling, redness of soft tissues. Even after the treated osteoarthritis, chronic processes cause the appearance of osteoarthritis.
Disorders of metabolic processes often lead to pathologies of the musculoskeletal system. Bones and joints lack nutrients and minerals needed for tissue strength. In their absence, bones and cartilaginous surfaces are subject to destructive processes, so even with a light load, primary osteoarthritis is visible.
Symptoms
Osteoarthritis of the knee joint manifests itself with a complex of features that are difficult to miss. Signs are felt not only in the first degree of pathology, but also in the second and third degrees give different symptoms of osteoarthritis of the knee joint:
- pain- is one of the main symptoms that are not immediately visible. An interesting fact is that with the development of osteoarthritis, the pain may not be felt for months or years until the disease worsens. Usually, the first symptoms of pain are discomfort during physical exertion, walking or running, but they also manifest themselves when the meniscus is compressed. With the second degree of osteoarthritis, the pain in the joint is felt more strongly, and with the third degree of development, the painful sensations appear even at rest. Attacks are aggravated even after short walks without a strong load on the joint, so patients try to spare their knees;
- deformations- In the third stage of the development of osteoarthritis, the manifestations become more pronounced. The knee will retain its normal shape, but will appear slightly swollen and edematous. When arthritis is combined, the knee will turn red, hot and painful to the touch;
- crunchappears in the second and third degrees of disease development with osteoarthritis. Crunching sounds are different from healthy clicks that can sometimes be heard when the knee is extended and bent. Symptoms in osteoarthritis are characterized by a dry, rough sound that is acute and accompanied by pain;
- synovitis- accumulation of a certain amount of fluid in the joint cavity. It's there and it's normal. However, excessive accumulation leads to the development of a cyst - the most noticeable Baker's cyst, which can be identified in the unbent position of the foot;
- limited mobility in the knee- a typical sign of pathology, because patients first consciously try to protect themselves from pain, and in the final stages of osteoarthritis, they are generally unable to straighten the environment. In the third stage of development, deforming osteoarthritis of the knee joint (DOA) causes complete loss of movement. Patients adapt to moving on bent legs when using support devices.
Development rates
There are three stages in the development of osteoarthritis of the knee joint.
Pain with grade 1 osteoarthritis is insignificant and occurs only with active physical force in the knee joint. Already in the first degree fluid can accumulate in the cavity, in the second and third excess cysts. With progress, pain occurs during movement, but passes quickly. Externally, the deformity of the knee joint is invisible, so the diagnosis of osteoarthritis of the knee joint can be difficult.
Damage to cartilage tissue is more important with secondary disease. If you take an X-ray, then the stage of bone growth is already noticeable. With any movement, a sharp sudden pain appears in the knee, but by returning to a relaxed position, the knee no longer hurts. In the second stage of DOA, you may hear a crisis characteristic of osteoarthritis. As you progress, the problems with knee extension and flexion worsen. The deformation is noticeable from the outside.
Osteoarthritis of the third knee joint is characterized by significant thinning of the cartilage tissue. Gradually, the cartilage becomes so old that in some places the bone remains exposed. The X-ray shows a significant amount of osteophytes - bone growths, salts visible in the joint space. Externally, the changes are clearly visible and the patient is worried about constant pain. Diagnosis is not difficult - visual examination is sufficient and X-ray control is performed.
With the progression of this degree, osteoarthritis can lead to complete loss of functionality. At any stage of pathological development, osteoarthritis of the knee joint may be associated.
Treatment
Osteoarthritis of the knee joint is not easy to cope with, especially if the disease has progressed or the inflammation has combined and arthritis has developed.
conservative
The most active group of drugs against osteoarthritis are non-steroidal anti-inflammatory drugs. These are primarily cyclooxygenase-2 inhibitors, which can perfectly eliminate inflammation, swelling and promote rapid recovery.
These drugs have significant limitations, so they should not be used without a doctor's advice. For example, they can aggravate gastric ulcers, heart disease, pathology of the urinary tract. Non-steroidal anti-inflammatory drugs are also prohibited during pregnancy.
The second group of agents are chondroprotectors that improve the properties of cartilage tissue. They are used for osteoarthritis to restore the proper structure of cartilage, because in the process of dissolution loses very important components - chondroitin and glucosamine. Therefore, almost all chondroprotectants contain both of these substances, but some drugs have a single component.
With the help of these drugs it is possible to help the patient in the first and second stages of the disease, but not in the third when irreversible changes occur.
During conservative therapy, the doctor will also give recommendations on nutrition. If the patient or patient is overweight, it is mandatory to follow a diet to normalize weight. How to gain a stable weight - the doctor will tell. It is also not recommended to eat a lot of salt, but it is better to supplement the diet with calcium, vitamins and minerals. Jelly, jelly will be useful.
Operation
The most common type of surgery for osteoarthritis is arthroscopy, but other interventions are performed. Treatment of osteoarthritis of the knee joint is usually carried out in the second and third degree, when conservative therapy no longer helps.
If minimally invasive intervention is required, for example when fluid accumulates in the knee joint, puncture can be performed. A puncture is made in the cavity of the knee joint and the excess fluid is pumped out. This method can be used both to diagnose and treat the disease. Fluid intake is minimal at the initial stage, but it already significantly improves the well-being of patients. After the biomaterial is examined, another part is removed and corticosteroids are injected into the joint space.
Arthroscopy is the most common. A number of tools are provided that allow the examination of the joint through a small incision in the skin and the necessary manipulations there. With the help of arthroscopy, it is possible to remove tissue particles from the cartilage, but there is always a risk of secondary gonarthrosis.
Periarticular osteotomy is needed with severe injury. This is a wider effect on the joint, as a result of which it is slightly filled and placed at any angle. Rehabilitation after surgery takes longer, but the effect lasts longer.
Significant destruction of articular elements leads to complete immobilization of the joint. The joint does not perform its function, ie it must be replaced and operated on. Endoprosthesis of the knee joint is an expensive operation, but it only allows the patient to return to the surrounding movement. Various knee prostheses are installed - plastic, ceramic or metal. These are sustainable structures that allow you to forget the problem for decades.
Physiotherapy
Physiotherapy methods can be used only after the acute period and the patient recovers.
Active methods include:
- ozone therapy- ozone exposure to the affected joint and the substance can be injected or used as an external treatment. Such care for patients is very effective, so it is often used in the treatment of various pathologies, including osteoarthritis. The treatment allows to activate blood circulation in the problem area, to achieve anti-inflammatory and analgesic effect. At the same time, treatment with glucocorticoids;
- kinesiotherapy- Treatment is carried out with the help of a special set of exercises. The load is formed taking into account individual data, and special simulators are used to strengthen the joints during training. The difference between kinesiotherapy and physiotherapy exercises is that they have an active effect not only on osteoarthritis of the knee, but on the whole body as a whole.
Apply not only ozone therapy and kinesiotherapy, but also physical therapy. The author's training methods for overcoming knee osteoarthritis give good results. During and after exercise, you may need to wear a special knee brace to strengthen the right or left knee joint.